How To Find The Early Clues Of Chronic Kidney Disease

A Sobering Study

"A Chinese epidemiological study showed that the proportion of patients with chronic kidney disease (CKD) stage 3 is high, about 12%. The proportion of patients with CKD stage 4-5 (ie, end-stage renal disease, ESRD) is significantly reduced, about less than 1%, which is low compared to the West." Is this data good or bad? It needs to be viewed dialectically from the point of view of dividing into two. First of all, among such a large CKD stage 3 population, only a small number of patients progressed to ESRD, which means that during this period, many patients failed to fight the disease to reach CKD stage 4-5, and passed away.

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After narrating such a heavy and cruel current situation, Professor Xue Jun changed the topic and started with this. So, what are the reasons that lead to the progress of CKD? And what causes CKD stage 3 patients to pass away before they have progressed to the terminal stage?

What "black hands" are driving the progress of CKD?

The first cross-sectional survey of CKD in China published in The Lancet by the nephrology team of Peking University First Hospital showed that the prevalence of CKD in my country is 10.8%, with a population of more than 130 million.

According to the traditional concept of nephrology, the etiology of most patients with nephropathy is related to primary autoimmune diseases. Among young kidney patients in my country, IgA patients account for the highest proportion; while among elderly patients, membranous nephropathy accounts for the highest proportion. In addition, with the improvement of material living standards and the westernization of living habits, secondary kidney damage caused by metabolic diseases shows a linear upward trend. Specifically, kidney disease caused by metabolic diseases such as diabetes, high blood pressure, and high uric acid has gradually accounted for an increasing proportion of middle-aged, elderly, and young adults, which requires the attention of people from all walks of life.

Preventing and improving the above factors can not only delay the progression of CKD but also prevent the occurrence of cardiovascular and cerebrovascular diseases. It is worth noting that nearly half of CKD patients died of cardiovascular and cerebrovascular complications. Professor Xue Jun believes that most of these risk factors leading to the progression of CKD are controllable. In order to delay the progression of CKD and prolong the survival time of patients, active measures need to be taken to deal with.

Grasp the early clues of CKD

The early symptoms of CKD are hidden, but there are still some clues for us to discover the disease. Therefore, we need to strengthen the awareness of prevention and improve the ability to observe.

blood pressure

Young people should pay special attention to the detection of blood pressure because their body has a strong tolerance. When blood pressure has risen, there are few obvious symptoms, so they cannot be detected early, and high blood pressure will cause damage to the kidneys. Taking chronic nephritis as an example, a very high proportion of patients will be accompanied by high blood pressure. if there is a need or conditions permit, you can prepare a sphygmomanometer at home, and choose the two periods of high blood pressure in the morning and in the evening to measure your blood pressure to know your blood pressure level.

the urine

Urine is also a window to indicate kidney disease. Due to the impairment of the filtration function of the glomerular filtration membrane and the reabsorption function of the renal tubules, the urine protein in the urine increases, and the formation of persistent foamy urine is an obvious sign. hint. At the same time, abnormal urine color and urine smell may be a manifestation of kidney damage, which deserves people's attention.

systemic symptoms

In addition to local changes such as blood pressure and urine, kidney disease can also cause systemic changes, such as anemia, fatigue, and backache when kidney function is impaired. Patients with hyper uric acid stone-associated nephropathy may present with joint pain, gross hematuria, and significant low back pain.

Reaching the blood pressure target is the focus of the prevention and treatment of CKD

We should pay more attention to blood pressure. Regrettably, although the incidence of hypertension is relatively high in our country, the compliance rate and awareness rate of blood pressure control are not satisfactory.

Compared with healthy people, CKD patients have stricter blood pressure control. The Global Kidney Outcomes Organization (KDIGO) proposes that the systolic blood pressure target of CKD patients should be<120mmHg, and KDIGO proposes that intensive antihypertensive therapy can bring additional cardioprotective, survival, and cognitive benefits, (this recommendation does not apply to kidney transplantation or patients receiving dialysis) [1]. Under this goal, the number of patients meeting the standard in my country is very small. Hypertension has an important impact on the progression of kidney disease and cardiovascular and cerebrovascular complications. Therefore, reducing blood pressure should be an important task in the prevention and treatment of CKD.

In addition, problems in daily life are generally a concern for patients with kidney disease. The professor pointed out that problems in this area require different lifestyle and dietary interventions according to the various stages of CKD.

In the early stage of the disease, you can take a balanced diet to supplement nutrition; when the disease progresses to the end stage, you need to strictly control protein intake and supplement α-keto acids to correct the malnutrition caused by the low protein. Although at different stages, the focus of nutritional therapy is different, they are all aimed at reducing the burden on the kidneys while ensuring that nutritional intake meets the standard.

Are your metrics up to par?

The young and middle-aged population is the key group for the prevention and treatment of CKD because the disease usually has a long course. Taking IgA nephropathy as an example, the course of the disease can reach decades from diagnosis to end-stage renal disease. Patients who progress to ESRD may It is more than 30%. Seeing such a high probability result, in addition to feeling afraid, young people should be more vigilant and strengthen their awareness of prevention.

Contemporary young people should develop good living habits and avoid high-salt, high-purine, high-fat, and high-carbohydrate diets. Avoid sitting for a long time, and at the same time, according to your own situation, you can increase the amount of exercise to improve your metabolic balance. The professor emphasized that "young people should move more".

At the same time, regular physical and biochemical examinations should be carried out to have a comprehensive understanding of their own metabolism and indicators. Metabolic abnormalities can be improved in the early stage by improving lifestyle or drug adjustments to help the indicators reach the target. It would be a pity if people ignore these checks in the early stage and cause the disease to progress to the point of no return.

Diseases related to the immune system, such as IgA nephritis and lupus nephritis, have a long course of disease, and the development of the disease is a dynamic process. For such patients, it is necessary to maintain healthy living habits and strictly pay attention to their own indicators. Accept long-term and standardized systemic treatment in order to delay the time of entering ESRD as much as possible.

for more information: ali.ma@wecistanche.com